The Heresy of African-Centered Psychology · The Heresy of African-Centered Psychology Naa Oyo A. Kwate1 This paper contends that African-centered models of psychopathology represent

Journal of Medical Humanities, Vol. 26, Nos. 4, Winter 2005 ( C© 2005)DOI: 10.1007/s10912-005-7698-x

The Heresy of African-Centered Psychology

Naa Oyo A. Kwate1

This paper contends that African-centered models of psychopathology representa heretical challenge to orthodox North American Mental Health. Heresy is thedefiant rejection of ideology from a smaller community within the orthodoxy.African-centered models of psychopathology use much of the same language andideas about the diagnostic process as Western psychiatry and clinical psychologybut explicitly reject the ideological foundations of illness definition. The nature ofthe heretical critique is discussed, and implications for the future of this school ofthought are offered.

KEY WORDS: African Americans; African-centered psychology; cultural psychiatry; heresy;nosology.

For some time, African American scholars have written about the need toincorporate issues of race and culture into the practice of psychology. 2 In addition,some psychologists have applied cultural concepts to specific groups within theDiaspora, such as Caribbean Americans.3 Initially, there was a great deal of resis-tance to accepting these ideas. Indeed, psychological models of theory and practicethat emphasize cultural concepts regarding African Americans, Asian Americans,Latin Americans, and Native Americans are still not considered “mainstream,” butrather, “ethnic minority psychology.” However, over time, these challenges to theorthodoxy have been tolerated within what Wolpe calls a controlled cultural spacefor noncomformist thought.4

1Address correspondence to Naa Oyo A. Kwate, Ph.D., Department of Sociomedical Sciences, Mail-man School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032; e-mail:[email protected].

2Though this work is too voluminous to review in detail here, the reader is referred to Boyd-Franklin,Carter, and Greene’s, “Considerations in the Treatment of Black Patients by White Therapists.”

3See Brent and Callwood, and Gopaul-McNicol.4Wolpe, “The Holistic Heresy,” 913–923.

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African-centered psychology has pushed the cultural psychology envelopeby making the cultural foundation more stringent: psychological theories in thisschool rest more strongly upon traditional African cultural thought and behav-ior. In this regard, African-centered theories of psychopathology are unique toindividuals of African descent and do not use the American Psychiatric Associa-tion’s Diagnostic and Statistical Manual (DSM) as the diagnostic foundation. InAfrican-centered psychology, mental disorder does not refer solely to individualintra-psychic malfunction but includes a larger context of social and political real-ity. Mental health is defined by that which promotes the survival and liberation ofpeople of African descent, both individually and collectively. In turn, dissonancefrom traditional African value systems and collective survival is what constitutesdisorder. Brought to the fore is a richer matrix within which to conceptualize andtreat dysfunctional behavior.

This paper argues that African-centered models of psychopathology are aform of heresy to North American Mental Health (NAMH). Heresy occurs whena subgroup attacks the orthodoxy from within, using much of the same language,but reinterprets reality and reframes values in novel terms. Heresy also includes acomponent of defiance, as this is what defines the position as something other thanignorance or error.5 In addition, heresy can only come from someone without thepower to define ideological orthodoxy, not from the ruling elite. It is important tonote that other challenges take place in science, but not all of them are heretical. Forexample, challenges to knowledge products (whatever the professions “sell” to thepublic) and to authority (i.e., the right of the profession to define its jurisdiction)are not heretical but simply dissent and rebellion, respectively.6 Heresy attacksideology itself, calling into question the linguistic constructs and legitimacy of theorthodox cultural model.

African-centered models of psychopathology exemplify these characteristicsof heresy. First, the models are proposed by psychologists of African descent, asubgroup of NAMH; these models did not originate outside psychological dis-course. In addition, this subgroup is not part of the power-wielding elite thatcategorizes and defines mental illness in society. Second, African-centered mod-els are defiant, in that they ardently reclaim the power to define illness ratherthan allowing that power to remain solely in the purview of orthodox psychiatry.Akbar cogently argues that the ability to decide who is sane or insane is one of theultimate measures of power and community integrity.7 African-centered modelsexplicitly reject orthodox notions of mental illness from within NAMH by: 1) us-ing communal rather than individualistic reference points for diagnosis; 2) openlyacknowledging and integrating the politics inherent in diagnosing abnormality;

5Wolpe, “The Dynamics of Heresy in a Profession,” 133–1148.6Ibid.7Akbar, “Mental Disorder Among African-Americans,” 18–25.

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and 3) referencing traditionally African, rather than European, cultural thoughtand behavior.

This paper will examine the heretical challenge of African-centered psy-chopathology by articulating the boundaries of African-centered heresy, review-ing the ideological tradition of orthodox NAMH and discussing the implicationsof a heretical stance on the growth of African-centered diagnosis and treatment.Here, NAMH refers to clinical psychology and psychiatry collectively. Althoughthe two disciplines focus on different aspects of mental illness (e.g., psychother-apy vs. pharmacotherapy), they share several fundamental similarities. First, bothagree that mental illness is an individually-defined construct. That is, illness occurswithin the psyche or within the neurobiological substrates of the brain. Second,both disciplines generally reject an emphasis on societal processes. Third, bothdisciplines presume the universality of illness, such that illness constructs arepresumed to be applicable to all human beings. Thus, depression is depression,wherever and in whomever it might occur; there is no such thing as a gender-specific depressive disorder, for example. In addition, both disciplines use thesame nosology of mental illness, the Diagnostic and Statistical Manual for MentalDisorders (DSM).8 Finally, both disciplines are founded on Eurocentric values andbehaviors.

It is also important to recognize that each discipline relies on the other tomaintain the boundaries and legitimacy of the profession. Psychiatry needs clinicalpsychology in order to show why some disorders require biomedical interventionand to reify the categorization of psychiatry as a medical science. In turn, clinicalpsychology needs psychiatry to show why not all mental disorders can be easilycured with pharmacotherapy; deep-rooted intra-psychic conflict is best solved bytalk therapy. Also, because psychologists do not have the power to define illnesscategories, they can only treat those who meet criteria for mental disorder as givenby psychiatry. Psychologists may see patients in their private practices that have“Messed Up Disorder NOS,” but any treatment that takes place in the context ofreimbursement by the health care system requires a DSM diagnosis. Thus, clinicalpsychology is not only wedded to but also dependent on the maintenance of thediagnostic orthodoxy. This includes the acceptance of the apolitical, universalisticstance underlying psychiatry. African-centered psychology’s heresy lies in therejection of this stance.

AFRICAN-CENTERED PSYCHOLOGY

One could make the claim that culturally-specific models are necessary be-cause, when the standard nosological system has been applied to individuals of

8American Psychiatry Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed.(Washington, DC, 1994).

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African descent, diagnostic inequities have resulted.9 These studies reveal thatNAMH has not provided culturally-appropriate care for individuals of Africandescent. African-centered psychology goes further, into heresy, by calling intoquestion the legitimacy of the fundamental orthodox ideologies using a culturally-specific cosmology and survival thrust and arguing that traditionally Africanworldview and behaviors best represent “normal” or optimal behavior. Conversely,deviance from traditional African cultural thought and behavior, over-reliance onWestern ideology, or negativism towards the African/African American collectiveis categorized as disordered. Putative disorders in this framework are describedbelow.

Alien-Self Disorder

Individuals with this disorder have been socialized to be other than them-selves, resulting in primarily materialistic goals, such as social affluence andprestige, and membership in “exclusive” organizations. There is a denial and/orindifference of social realities, particularly as they relate to race and oppression,and an emphasis on imitating the dominant group.10

Anti-Self Disorder

Individuals with this disorder add the dominant group’s projected hostility andnegativism toward African Americans to the characteristics of alien-self disorder.As a result, these individuals may engage in behaviors that are detrimental to theircommunities and are more attentive to outgroup approval.11

Individualism

Individuals with this disorder adhere to European-centered “rugged individ-ualism.” Value is placed on the desire and practice of being unique or differentand primarily “looking out for number one,” and a communal orientation isrejected.12

Mammyism

This condition refers to certain behaviors thatAfrican American women ex-hibited during slavery as a means of survival, including the presentation of being

9See, for example, Adembimpe, et al., “Racial and Geographic Differences in the Psychopathology ofSchizophrenia,” 888–891; Fabrega, Mezzich, et al.; Neal-Barnett, Smith, et al.; Strakowski et al. “TheEffects of Race on Diagnosis and Disposition”; Strakowski et al., “The Effects of Race and InformationVariance on Disagreement Between Psychiatric Emergency Service and Research Diagnoses in First-Episode Psychosis”; and Whaley.

10Akbar, “Mental Disorder,” 18–25.11Ibid.12Azibo, “African-Centered Theses,” 173–214.


non-threatening, nurturing and selfless, with demonstrations of love, devotion andloyalty to the oppressor rather than to the women’s own families. Today, someAfrican American women practice defunct slave-like social behaviors such astaking ownership of authority figures’ troubles (e.g., employers), demonstratingself-sacrifice and self-denial in order to benefit the White power structure, andsuccumbing to Eurocentric ideals of beauty. These behaviors, which are no longeradaptive, are considered Mammyism.13

Materialistic Depression

Individuals with this disorder use material goods (or the lack of them) asa major criterion for judging themselves and/or others. These individuals seekthe accumulation of money and status symbols that they regard as having someintrinsic value above and beyond their economic value.14

Self-Destructive Disorder

Individuals with this disorder engage in self-destructive behaviors such assubstance abuse, violence, and negative health behaviors. These behaviors areseen as attempts to survive in a society which frustrates efforts at normal growthand development.15

Theological Misorientation

Individuals with this disorder hold beliefs or allegiances to and engagein the practice of a theology or religion-related ideology incompatible withAfrocentricity or the African cosmology.16 These beliefs have often historicallybeen used in the service of African oppression. Azibo asserts that Africans through-out the world possess other people’s holy books, and that these other people nowpossess the previously African-owned resources. Theologically misoriented be-haviors can include depicting the Divine as of European descent or denigratingtraditional African spiritual systems.

Taken together, these “illnesses” reflect many of the psycho-spiritual andsocio-historical forces that threaten the well-being of individuals of African de-scent in a society powerfully underlined by racism and cultural hegemony. Bymarking a reference point for judging deviance rather distally (i.e., a traditionalAfrican ethos), African-centered psychology describes an idealized African self.Gaines states that “classifications are less attempts to classify disease than to ar-ticulate an idealized cultural-, age- and gender-specific self”;17 the DSM is indeed

13Abdullah, 196–210.14According to Braithwaite and Taylor as cited in Azibo, 1989.15Akbar, “Mental Disorder,” 18–25.16Azibo, “African-centered Theses,” 173–214.17Gaines, 19.

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an articulation of an idealized European self. African-centered psychology rejectsthe Eurocentric self and, with it, behaviors that embrace self-negation. Abdullahstates it plainly: “to devalue one’s culture is a disorder.”18 The heterodoxy of suchan assertion is easily seen. However, a review of basic tenets of orthodox NAMHis necessary to illuminate fully the heresy of African-centered psychology.

THE ORTHODOX IDEOLOGY OF NAMH BIOMEDICALEPISTEMOLOGY AND DISEASE CLASSIFICATION

In 1968, Erwin Ackerknecht described psychiatry as the youngest branch ofmedicine, one which suffered from the hostility directed against the mentally illpatients it treats.19 Alexander and Selesnick also claimed that in psychiatry’s earlydays,

. . . while psychiatry was considered a part of medicine, it was kept in a marginal position.The psychiatrist was primarily a custodian and not a healer. And, were it not for mentaldisturbances that apparently were due to physical causes, the psychiatrist would have hadno contact with his fellow physicians or even a common language with them . . . in ourcentury a scientific revolution has taken place: psychiatry has come of age. On the strengthof substantial achievements, it has ceased being medicine’s neglected stepchild and becomeone of the most prominent fields in medicine.20

Today, psychiatry consistently ranks near the bottom in prestige hierarchiesamong physicians and/or medical students, and psychiatrists are often not rec-ognized as medical doctors by lay people.21 As a result, psychiatry contin-ues to resist stepchild status via a rigid epistemology of biomedical constructsthat exclude sociopolitical concepts. Once practiced primarily from a model ofpsychoanalytically-oriented treatment, psychiatry has become increasingly fo-cused on pharmacotherapy and biological substrates of disorder. Psychiatry tendsto operate from a defensive and dogmatic adherence to the ideology of modernismand displays a fetishized preference for science.22

Psychiatric training is largely oriented towards treating psychopathology asbrain dysfunction, as an organic disease process to be uncovered and treated withmedication. Psychiatric residents are taught to conceptualize mental anguish asif it were cardiac disease, whereby psychosis and depression become written onthe body. Much is at stake in maintaining such a position. Psychiatry’s very statusas a legitimate medical specialty is dependent on its adherence to a nosologyof disorder based on the mind and measurable, “objective” treatments such asdrug therapy.23 Indeed, Gaines argues that DSM-III’s move from psychological

18Abdullah, 205.19Ackernecht.20Alexander and Selesnick, 4.21Rosoff and Leone, 321–326.22Lewis, 71–84.23Fernado.


to biological explanations of mental disorders is a result of psychiatry’s need torationalize and justify the increasing use of pharmacological treatments.24

As psychiatry has fought a long battle to become respected as a “hard” sci-ence so, too, has psychology. In 1913, Watson argued that the proper focus ofpsychology should be on objective, observable behavior rather than the “unscien-tific” introspection paradigm.25 Similarly, Helmholtz is credited as being a greatpioneer of psychology for revealing that neurological processes could be subject torigorous laboratory experimentation, as well as for integrating “lawful and mecha-nistic” principles of sensation.26 Piaget is also lauded for stressing the organic andbiological nature of the mind. As psychology moved away from a psychophysicsparadigm, an emphasis on mental process with an attendant disconnection to thebody became prominent. Descartes is thought to have created the groundwork formodern psychology,27 and he is famous for stating, “I think, therefore I am.”

Today, treatment in NAMH is firmly bound by Cartesian mind-body dual-ism. For example, treatment focuses on “mental” problems and observes whenpatients are “somatisizing.” Gaines makes a stronger point: the very existenceof psychiatry as a discipline reveals the dualism in U.S. medicine; without it, thedisease classifications for psychiatry and medicine would be the same.28 Althoughpsychiatry uses a different classification schema than the rest of medicine, it relieson the same methods and boundaries in characterizing illness.

For example, a fundamental notion in NAMH is that psychiatric illnessesare discrete entities that are “discovered” in nature. Moreover, neurobiologicalcorrelates (e.g., neurotransmitter activity) are taken as evidence that psychiatricconstructs are analogous to the diseases typically treated by allopathic medicine.However, even medical disease categories shift historically; in seventeenth centuryEngland, individuals were classified as dying from such varied afflictions as “itch,”“cut of the stone,” “grief,” “Mother, rising of the lights,” and “Stopping of thestomach.”29 Too, understanding the etiology of classified diseases has changedfrom a moral valence emphasizing sinfulness to present day secularized biomedicalparadigms. Yet, NAMH acts as if psychiatric classification systems are scientifictruths, rather than culturally constrained rules, which are not naturally occurringphenomena.30

The fluidity of psychiatric nosological rules reveals that disorders are, in fact,constructed rather than discovered. For example, Passive-Aggressive PersonalityDisorder was a diagnostic label in DSM-III and DSM-III-R, but upon the publi-cation of DSM-IV, it was only a “criteria set under further study.” By the timeDSM-V is released, it may well be again defined as a mental illness. Blashfield

24Gaines, 3–2425Fancher.26Ibid.27Ibid.28Gaines, 3–2429Bowker and Star.30Szasz.

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and Fuller found that the number of pages associated with each edition of the DSMhas steadily increased.31 And, as the number of pages and words has increased,so have the diagnostic categories. In DSM-I, there were 128 total disorders; inDSM-IV, there are 357. The authors contend that the growth process associ-ated with the DSMs has passed reasonable bounds, and scientists should beginsorting out which of the existing categories represent valid diagnostic concepts.The growth of putative mental disorders reflects the reality that these diagnos-tic categories do not represent naturally occurring diseases; even schizophrenia,the most “serious” mental disorder, has no symptoms that are unique to it as asyndrome.32

It is ironic that NAMH has yet to explicate what is “normal” functioning. Inthe final analysis, normality can only be described as whatever is not in the DSM.33

In any case, psychiatric classification is often defined by the symptoms themselves.For example, a child who acts oppositional is said to have Oppositional DefiantDisorder, a supposed discrete mental disorder. In pediatrics, a child who vomitswould not be diagnosed with “Vomiting Disorder”; this symptom would be inves-tigated for any number of disease processes. NAMH’s narrow focus on symptomsneglects socio-cultural determinants of illness and relies on psychiatric “truth” be-ing revealed in abstract, depoliticized concepts. Psychiatric disorders are routinelyshorn of cultural epiphenomena,34 precluding a contextualized understanding ofbehavioral dysfunction.

EUROCENTRISM AND CULTURAL FOUNDATION

At worst, NAMH reflects deeply racist ideologies that are cloaked in scientismand objective truth. For example, in 1913, Evarts argued that slavery was, in fact,beneficial to Africans because imitating European slave owners ameliorated theirlacking mental initiative.35 This “scientific” view was consonant with the socialmores at the time, which saw Africans as more animal than human. A few yearsprior to the publication of this paper, Africans from the continent were beingdisplayed at the St. Louis World’s Fair with monkeys.36 Evarts’ paper is ostensiblya scientific treatise on the mental status of Africans but is clearly little morethan rationalization for the racist behavior that governed the United States–whatFairchild terms scientific racism.37 Indeed, Western science has often attemptedto support what Thomas and Sillen describe as two basic themes of racism.38 The

31Blashfield and Fuller, 4–7.32Gaines, 3–24.33Haley.34Fabrega, “Culture and History in Psychiatric Diagnosis and Practice,” 391–405.35Evarts, 388–403.36Guthrie.37Fairchild, 101–115.38Thomas and Sillen.


first theme is that Black people enter the world with inferior brains and limitedcapacity for mental growth; the second is that the Black personality is abnormal,whether by nature or nurture.

As recently as 1973, Henry Garrett, a past president of the American Psy-chological Association, stated that the Black man’s brain is on average smallerand less complex than those of Whites; this was given as supporting evidenceagainst racial integration.39 An oft-cited problem-solving heuristic is Thomas’“missionary-cannibal” problem where “three missionaries and three cannibalsstand on one side of a stream, with a boat capable of carrying just two people. Allsix people are to be transported to the other side. At least one person must be inthe boat during each crossing. Cannibals must never outnumber missionaries oneither side of the river.”40

At best, the Eurocentric worldview underlying NAMH tends to see cultureas a separate category of human experience which generally “complicates” one’sunderstanding of people41 and conceptualizes individuals of European descent asthe normative standard. For example, a case book published soon after DSM-IVdid not include the terms “race,” “culture,” or “ethnicity” in the index at all, andcase studies list only the sex, age, and occupation of the patients described.42 TheDSM-IV itself failed to incorporate adequately culturally-based text, resulting ina “Cultural Formulation Outline” being placed in the Ninth Appendix rather thanthe Introduction, as was proposed.43 Other sections on cultural considerationswere also omitted entirely.44 In addition, references to culture throughout thebook were scarce, superficial, and disguised or enmeshed with age, gender, andsocioeconomic factors.45

Gaines argues that the DSMs represent a Northern Germanic, adult malevoice and that the DSMs reflect particular cultural-historical processes by whichcertain ethnic Western selves comment on themselves or others.46 The “self” inEuropean thought has been described as enclosed by boundaries of individualism,personal control, and a self-concept that excludes other persons.47 By extension,the theoretical foundations of psychotherapy include Eurocentric values, suchas individualism, rational and scientific thinking,48 action orientation, status andpower, and the Protestant work ethic.

These values are viewed as catalysts for scientific progress and healing.In psychiatry, emotion is an insult to the ideal self; it is distinct from rational

39Guthire.40Cited in Baron.41Hays, 309–315.42Frances and Ross.43Mezzich, et al. “The Place of Culture in DSM-IV,” 457–464.44Mezzich, et al., “Culture in DSM-IV,” 407–419.45See Alarcon, 260–270 and Kleinman, 343–344.46Gaines, 3–24.47Dana.48Comas-Diaz and Greene.

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thought and the enemy of balance and control.49 Emotion is generally an insult tothe structure of the European scientific process which underscores “objectivism.”Modern medicine itself is founded on a disregard for the personal sentiments ofthe researcher.50 Thus, a synergy of science and spiritual concerns is viewed withsuspicion and skepticism, if not outright hostility. Oshodi states that Americanpsychology maintains alliances with the framework of natural sciences such asphysics and chemistry, and that a distinct element shared by these areas of science isantispiritualism.51 He also points out that what are viewed as scientific revolutionsin psychology, in fact, represent different periods of myth. Psychoanalysis, forexample, though couched in the lingo of empiricism is, in essence, a mythologicalsystem; indeed, Watson reportedly called it, “voodoo.”52

In summary, the ideological understructure of NAMH is founded on Eurocen-tric values of individualism, hierarchy, rational thought, and anti-spiritualism andis realized in a biomedical approach to illness. These values stand in stark contrastto an African-centered worldview,53 and thus are inappropriate as a diagnosticfulcrum for individuals of African descent. Here, core values such as collectivisticand spiritual orientations are salient among varied groups throughout the Diaspora,as briefly reviewed below.

AFRICAN CULTURAL THOUGHT AND BEHAVIOR

A deep sense of spirituality and oneness with nature is focal in African culturalthought and behavior. Mbiti argues that he has not come across a single Africanpeople who do not have knowledge of God.54 Among the Yoruba, the presence ofdivine spirit is felt to be constant, and in all undertakings, individuals put divinityfirst and call upon spiritual blessing, support, and succor.55 An emphasis on ahigher life-force and connectedness to spirit also affects other aspects of life, suchas concepts of time. Because time is seen as inseparable from the life force, therhythm of time is not seen as quantifiable and constant. Rather, time is simply partof the natural essence of actual experience. A spiritual orientation also translatesinto a harmonious relationship with nature.

The value of collective orientation rather than individualism is well docu-mented in African historical and anthropological literature. Mbiti states that:

. . . in traditional life, the individual does not and cannot exist alone except corporately. Heowes his existence to other people, including those of past generations and his contempo-raries. He is simply part of the whole . . . only in terms of other people does the individual

49Gaines,3–24.50Gursoy, 577–599.51Oshodi, 172–182.52Ibid.53See Azibo, “Articulating the Distinction,” 64–97; and Baldwin, 216–223.54Mbiti, “Man in African Religion.”55Bolaji Idowu.


become conscious of his own being, his own duties, his privileges and responsibilitiestowards himself and towards other people.56

He discusses the ways in which African fables stress the value in groupsolidarity and the danger in individualism.57 Finally, an ethnographic account ofthe Zhun/twasi (!Kung), a hunter-gatherer group in southern Africa, illustrates theimportance of collective responsibility and acknowledgment of the group. Amongthe !Kung, when obtaining food, most hunters alternate hunting with long periodsof inactivity, in order to allow others to receive praise and attention from thegroup.58

In the African worldview, relationships with others also extend into the pastand future, and concepts of health are imbued with this notion of extended self.Ogbonnaya states that the idea of “a single self constricted within a physical prisoncalled the body, whose only health is to remain monolinearly focused, can hardlybe said to be African.”59 In classical and traditional African medicine, diseaseis viewed as personal and collective disharmony, wherein the afflicted is out ofbalance physically, spiritually, and with the community.

In traditional African societies, the concept of kinship is paramount in socialorganization and sense of self, both individual and collective. Mbiti describeskinship as controlling social relationships and determining the behavior of oneindividual toward another.60 Indeed, this sense of kinship is even extended tocover animals, plants, and non-living objects. Wright describes the ways in whichkinship networks were carried over to North America during the slave trade,61 andBoyd-Franklin illuminates how these networks continue to serve as a fundamentalway of being in African American communities.62

Because African value systems center on interpersonal and spiritual connect-edness, there is a consequent lack of focus on materialism. Opoku states that anAkan proverb recounts, “Onipa ne asem. Mefre sika a, sika nnye me so; mefrentama a, ntama nnye me so. Onipa ne asem,” which translates to, “It is the humanbeing that counts. I call on gold, gold does not respond; I call on drapery, but itdoes not respond. It is the human being that counts.”63 This proverb illustratesthat the centrality of wealth is derived by human contact and quality of relation-ships rather than possessions. Moreover, whatever material wealth one acquiresis expected to be shared amongst others. Owomoyela describes the protagonistof Yoruba trickster tales as being incomparable in his miserliness, a trait that isshown to be a character deficit in these tales.64

56Mbiti, African Religions and Philosophy, 106.57Boateng.58Shostak.59Ogbonnaya, 79.60Mbiti, African Religions.61Wright.62Boyd-Frabklin.63Opoku, 10.64Owomoyela.

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Taken together, these core values serve as the starting point for a diagnosticnormative reference point in African-centered psychology and are thought to beapplicable to all individuals of African descent. This means that although Africanswho lived through the particular cultural epochs of America faced very differentcircumstances from those who lived in the Caribbean or on the continent, thesetraditional core values are thought to supersede the idiosyncratic context of the newenvironments Africans faced. As a result, the significant variation in the Africanexperience is not addressed, despite the fact that African-centered “diagnoses”are based on experience and interpretation of that experience. The literature onAfrican personality assumes that Africans were all taken from the mother continentand sent to varied geographical locations, but that the core facets of expressedpersonality are derived from the original place of origin. Thus, the concept ofan African-centered psychopathology assumes that personality dysfunction forAfrican descendants can be assessed using the same deep cultural structure as theoriginal reference point, despite the fact that these values are not static, unchangingsystems.

Still, there is utility in thinking broadly about what it means for an individualto come from a heritage in which these values have historical weight. Just as termssuch as “Eastern philosophy” may paint a broad brush across a number of ethno-cultural groups but still retain some useful heuristics in thinking about worldview,the same is true for “African culture.” It is also important to note that peoples ofAfrican descent are not the only groups who are oriented towards collectivism;certainly, there is voluminous literature documenting such a worldview amongmany cultures. The critical factor here is that because African culture does tendto cohere around these values, a diagnostic paradigm which is founded on a setof opposite Western values and ignores relevant sociopolitical concerns, is lessuseful in this population.

THE FAILURE OF ORTHODOX NAMH

The DSM-IV diagnostic criteria of Antisocial Personality Disorder (APD)are illustrative of why orthodox constructions of mental disorder can misrepresentmaladaptive behaviors among individuals of African descent. The primary crite-ria for APD center on failure to conform to social norms with respect to lawfulbehavior, such as aggressive/assaultive acts, lying, stealing, destroying property,or pursuing illegal occupations. Other features of Antisocial Personality Disorderinclude “irresponsible work behavior” (e.g., significant periods of unemploymentdespite job opportunities) and “financial irresponsibility” (e.g., failure to providechild support). Associated features such as “history of many sexual partners,”failure to sustain a monogamous relationship, spending many years in penal insti-tutions, and a greater likelihood of dying prematurely by violent means are alsogiven. Finally, Antisocial Personality Disorder is stated as “associated with low


socioeconomic status and urban settings” and is reportedly “much more common”in males than females.65 The euphemisms above essentially refer to poor, Black,urban males, the most criminalized segment of American society.

Criminal and sociopathic behaviors have historically been attributed to Blackpeople, particularly males.66 It is interesting to note that “white-collar” crimes arenot seen as “antisocial.” Indeed, Nuckolls argues that “the prototypical antisocialperson whose behavior does not invoke criminal sanctions is powerfully equippedto function in the world of consumer capitalism.”67 What is missing from theAPD diagnostic schema is any contextual understanding of how and why these“antisocial” behaviors originate and are maintained.

For African-Americans, many of the terms and features that are used todiagnose APD have long-standing historical roots. For example, Akbar discusseswork in the African-American community and its connection to the forced laborof slavery. He points out that during slavery, work was not only a chore butalso a punishment, which began in early childhood and continued until death ordisability.68 Moreover, this work was entirely to the benefit of the slave owners. Asa result, Akbar argues, work is often equated with enslavement and freedom withthe avoidance of work. Clearly, these factors alone do not explain patterns of workor unemployment among African Americans. Factors such as institutional racism,educational inequities, job availability and economic conditions are real obstacles.However, when taken together, these factors remind us to consider social context,both present and historical, in diagnosing “mental disorder.”

The associated features of sexual and parenting behaviors in APD are alsoclearly related to broader forces. Akbar’s discussion also reveals the enduringlegacy of slavery on the African-American family.69 During this time, African-American manhood was systematically denied. Rather than providing for andprotecting his family, the African man was evaluated by his ability to withstandstrenuous work and to impregnate women to create more slaves. Any attempts toassert himself as a man or to engage in more appropriate representations of man-hood were punished severely, potentially by death. Today, in many communities,some African-American men continue to express their manhood through fatheringchildren. Akbar points out that men seeking to be men through sexual or physi-cal exploits is, in fact, predictable when natural avenues to manhood have beensystematically blocked.70 Similarly, many African-American women, includingadolescents, evaluate their own worth by being “breeders.”

Finally, in terms of criminal behavior and tendency to experience violentcrimes and incarceration, we again see that DSM-IV’s conception of illness is

65American Psychiatric Association, 647.66Greene, “Considerations in the Treatment of Black Patients,” 389–393.67Nuckolls, 45.68Akbar, Chains and Images.69Ibid.70Ibid.

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artificially abstracted and centered on individual character flaws. The diagnos-tic criteria ignore the fact that even law-abiding Black males are systematicallyprofiled by law enforcement as criminals, and that Black men are more likelyto be prosecuted and to receive harsher sentences than White men for the samecrimes. As a result, the etiology of criminal behavior remains to be articulatedin the diagnostic features of APD. Wright questions why African-American mencommit crimes in their own communities and die in violent ways; in other words,why they are programmed for self-destruction.71 Wilson contends that “the vio-lent Black-on-Black narcissistic criminal in his triumph reveals his self-contempt,cowardliness, and contempt for his people. His violent narcissism reveals thathe cannot believe his real self to be truly lovable . . . The Black-on-Black violentcriminal hates in other Blacks those characteristics he hates most in himself.”72

This analysis reveals an alternate way of conceptualizing violence, one that isinformed by culturally relevant life experience.

African-centered conceptions such as Self-Destructive or Anti-Self Disordermore fully illuminate the scope of many of the maladaptive behaviors describedby APD. Still, it is interesting to note that African-centered conceptions of dis-order are not at odds with the core DSM-IV definition of mental disorder. TheDSM-IV defines mental disorder as “a clinically significant behavioral or psy-chological syndrome or pattern that occurs in an individual and that is associatedwith present distress . . . or with a significantly increased risk of suffering death,panic, disability, or an important loss of freedom.”73 African-centered theoristswould agree that individuals of African descent who operate with anti-self val-ues are more likely to engage in behaviors that are destructive to themselvesand their communities, resulting in increased risk of death, disability, or loss offreedom.

In addition, the essential diagnostic feature of personality disorders inDSM-IV is described as “an enduring pattern of inner experience and behav-ior that deviates markedly from the expectations of the individual’s culture and ismanifested in at least two of the following areas: cognition, affectivity, interper-sonal functioning, or impulse control.”74 African-centered personality disorderssimply use African cultural thought and behavior as the reference culture, anddisorder is defined accordingly. Personality disorders defined in DSM-IV canalso “be complicated by the fact that the characteristics that define a Personal-ity Disorder may not be considered problematic by the individual (i.e., the traitsare often ego-syntonic).”75 The same is true for African-centered disorder. In-deed, Kambon argues that, by and large, culturally misoriented Africans do notexperience anxiety or confusion around their identity because the Eurocentric

71Wright, 15–17.72Wilson, 75.73American Psychiatric Association, xxi.74Ibid., 630.75Ibid., 630.


social system in the United States generally fosters and reinforces a Eurocentricworldview.76

AFRICAN-CENTERED PSYCHOLOGY’S HERETICAL CHALLENGE

Despite these areas of concordance, the heresy inherent in the African-centered paradigm is clear. African-centered psychology represents an attackon the orthodoxy both in rhetoric and in failing to maintain the institutional-ized self of NAMH. In terms of rhetoric, the deconstruction of universal mentalillness is heretical. As previously noted, NAMH is founded on a biomedically-constructed definition of illness whereby all people can become afflicted by anyillness. African-centered psychology rejects that premise and contends that in-dividuals of African descent can be diagnosed with disorders that are containedsolely within the group. When we imagine the idea of a DSM categorizing “Amer-ican” mental illnesses, the heresy of African-centered psychology is evident.Indeed, attempts at defining Western culture-bound syndromes in the DSM havebeen rejected by the orthodoxy of NAMH.77 Kleinman points out that 90% ofDSM categories are, in fact, culture-bound to North America and Western Eu-rope, but the “culture-bound” label is only applied to “exotic” syndromes outsideEuro-American society.78

By offering culturally-specific models, African-centered psychology unifiesvaried ethnic groups of African descent as a whole, an unorthodox concept inthe social sciences generally. Soyinka highlights the sense of “Africanness,” orcontinental unity various African groups share.79 For example, the Yoruba refer tothemselves and their descendants in the Diaspora as enia dudu, the black peoples.African-centered psychology is informed by this Pan-Africanist worldview andproposes that African people throughout the Diaspora could be diagnosed withany of the African-centered disorders.

The parameters of disordered behavior in African-centered psychology andthe distinction of a “natural order” make a definition of normal behavior explicit.As one example, Azibo describes the ultimate goal of intervention with a clientas fostering Africentricity.80 In other words, “normal” behaviors are those thatevidence a strong cultural identity and promote the sustenance of the group.NAMH resolutely refuses to define normal behavior, and, in any case, would notuse group-based norms as the criterion.

African-centered psychology’s illness definitions are heretical because theyare informed by social constructs located outside the scope of NAMH’s sup-posed scientific objectivism, individualism, and apolitical theory. By including

76Kambon.77Mezzich, et al., “Culture in DSM-IV,” 407–419.78Kleinman, 343–344.79Soyinka.80Azibo, “Treatment and Training,” 53–65.

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concepts such as identity, spirituality, community, and sociopolitical well-being,African-centered psychology has redefined the scope of science, and thus ques-tioned the institutionalized self. In addition, Wolpe suggests that a defining char-acteristic of a profession is the use of a common language that is only partiallyunderstood by outsiders.81 Disorders such as Alien-Self Disorder are framed ineveryday language and can be understood and even “diagnosed” by lay people.This linguistic shift breaks the ritualized secrecy surrounding NAMH.

Most importantly, an Africentric conception of mental health questions thevery legitimacy of psychiatry. As Wolpe contends, heretical beliefs divest the or-thodoxy of its cultural prerogatives.82 In this case, African-centered models areheretical because they debate who ought to have the power to define what isadaptive and what is maladaptive behavior. As noted earlier, the construction ofillness definition has heretofore been solely the province of medicine (psychia-trists). Here, psychologists have entered the forbidden city, and constructed illnessdefinitions that are not easily reduced to biomedical ephemera.

IMPLICATIONS OF A HERETICAL AFRICAN-CENTERED STANCE

What is the future of African-centered psychology’s heretical challenge?Holistic medicine has been described as a heretical movement in biomedicine,and although it was dismissed as quackery by the orthodoxy, “today, biomedicinenot only tolerates these cranks and magicians, it finds itself incorporating theirphilosophical positions into its medical model and their alternative therapies into itsmedical regimen.”83 This outcome can be conceptualized as co-optation; adoptingthe practices of a group without accepting them as practitioners.84 This processis one of several that may be used by the orthodoxy to force conformity by theheretic; others can include isolation, subjugation, absorption or suppression.

Perhaps most relevant to African-centered psychology is suppression, thefirst instinct of the orthodoxy.85 Heretics who go too far or press too hard canbe “excommunicated.” That is, because journals, university posts and fundingsources are controlled by the orthodoxy, scientists who make heretical chal-lenges can be isolated from orthodox institutional practices and find their worksuppressed.86

The African-centered literature has tended to appear within the relevant flag-ship journal, Journal of Black Psychology, or within other related, specializedjournals such as the Journal of Black Studies, or the Western Journal of BlackStudies. The end result is extremely limited visibility, significantly reducing the

81Wolpe,“Holistic Heresy,” 913–923.82Wolpe, “Dynamics of Heresy,” 1133–1148.83Ibid, 1134.84Ibid.85Ibid.86Ibid.


chances of a powerful heretical movement. Nagayama Hall and Maramba showedthat there is a paucity of cross-cultural and “ethnic minority” research published inAmerican Psychological Association journals, and African-centered psychologyis no exception.87

Sue reviews research that shows that few empirical articles have been pub-lished on African Americans.88 If “mainstream” research on African Americans iswanting, it is logical to expect that a heretical subgroup of literature would be giveneven less visibility. The orthodoxy regularly engages in defensive, ethnocentricperspectives when confronted with challenges to the cultural ideology and makesit difficult for cultural heretics to gain footing in the scientific discourse.89 Morerecently, several scholars have begun to question the utility of “race” in scientificresearch,90 further reducing the likelihood of race-based notions of mental disor-der being widely accepted. When we also consider that the Academy tends notto be receptive to psychologists of African descent who practice African-centeredpsychology, we are faced with a number of obstacles to a successful hereticalchallenge.

While a heretical stance has the potential to revolutionize the knowledgebase and practice of a field, it appears that even within the larger umbrella ofBlack psychology, African-centered psychology has perhaps been too hereticalfor its own good. That is, with the exception of relatively new work by preeminentscholars in the field, African-centered models of psychopathology have enteredinto a deep slumber and are relatively invisible even among psychologists whoemphasize culturally appropriate treatment.

Treatment models that are informed by Africentric thinking are abundant,91

and some writers have proposed alternative, culturally-specific DSM diagnosticparadigms. However, a fuller articulation of putative African-centered disordershas yet to appear in the literature. Such an exposition might include finely tunedcriteria directly translatable to clinical practice and empirical/epidemiologic in-vestigation of the constructs. Without such work, scholars who seek to employthese models are asked to base their work on theory alone. It is perhaps thisstate of affairs that has left African-centered mental disorders out of currentdiscourse.

It is also true that in order to conduct psychological research and practicefrom an African-centered perspective requires exposure to cultural concepts dur-ing training. NAMH has not made this a priority. For example, the AmericanPsychological Association’s task force on the “Delivery of Services to EthnicMinority Populations” was not established until 1988, after the APA had been in

87Nagayama Hall and Maramba, 12–26.88Sue, 1070–1077.89See, for example, Fowers and Richardson, 609–621.90See Helms and Tallyrand, 1246–1247; Oppenheimer, 1049–1055; and Thomas.91For instance, Belgrave, et al., 386–401; Franklin and Pack-Brown, 237–245; Longshore, et al.,

319–332; Cherry, et al., 319–339.

232 Kwate

existence for ninety-six years, reflecting the tendency to avoid examining issuesof difference, particularly due to discomfort.92 As late as 1994, 74% of pro-grams did not require even one course on diverse populations for completion ofthe doctorate, and 48% of programs preferred “generic” training. More recently,scholars have commented on the minimal integration of culture into curricularplans. Not surprisingly, clinicians often do not view themselves as competent toserve a diverse clientele. It is clear that the integration of culture is not a priorityof NAMH.

African-centered psychology should look to other models of cultural psy-chiatry for strategies in broader implementation. For example, Latin Americanpsychiatrists have a longstanding history in creating culturally viable diagnosticsystems for Latino populations. Described as local glossaries, nosologies suchas the Cuban Glossary of Psychiatry and the Latin American Guide for Psychi-atric Diagnosis provide culturally-specific formulations of mental disorder thatare based on the everyday experiences of users.93 This work has been extendedto such orthodox institutions as the World Health Organization (and its diagnosticsystem, the International Classification of Diseases). Whether African-centeredpsychological concepts will be implemented on this scale remains to be seen.However, in the final analysis, it is clear that African-centered psychology mustin some way broaden its scope to a larger stage or risk permanent suppression.

REFERENCES

A. S. Abdullah, “Mammy-ism: A diagnosis,” Journal of Black Psychology, 24 (1998): 196–210.E. H. Ackerknecht, A Short History of Psychiatry (New York: Hafner, 1968).V. R. Adembimpe, “Overview: White norms and psychiatric diagnosis of Black patients,” American

Journal of Psychiatry, 138 (1981): 279–285.V. R. Adembimpe, C. Chung-Cho, et al., “Racial and Geographic Differences,” American Journal of

Psychiatry, 139 (1982): 888–891.N. Akbar, “Mental Disorder Among African-Americans.” Black Books Bulletin, 7, No. 2 (1981):

18–25.N. Akbar, “Chains and Images of Psychological Slavery.” (Jersey City, NJ: New Mind Productions

1994).R. D. Alarcon, “Personality Disorders.” Journal of Personality Disorders, 10, No. 3 (1996): 260–270.F. G. Alexander, and S. T. Selesnick, The History of Psychiatry: An Evaluation of Psychiatric Thought

and Practice From Prehistoric Times to the Present (New York: Harper & Row, 1966).K. W. Allison, R. J. Echemendia, et al. “Predicting cultural competence: Implications for practice and

training.” Professional Psychology: Research and Practice (1996): 386–393.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th ed.).

(Washington, DC: APA, 1994).D. A. Azibo, “African-centered theses on mental health and a nosology of Black/African personality

disorder.” Journal of Black Psychology, 15 (1989): 173–214.D. A. Azibo, “Treatment and Training Implications of the Advances in African Personality Theory.”

Western Journal of Black Studies, 14 (1990): 53–65.

92Greene, 389–393.93Berganza, 443–446.


D. A. Azibo, “Articulating the distinction between Black studies and the study of Blacks: The fun-damental role of culture and the African-centered worldview.” The Afrocentric Scholar, 1 No. 1,(1992): 64–97.

D. A. Azibo, and P. Dixon, “The theoretical relationship between materialistic depression and depres-sion: Preliminary data and implications for the Azibo nosology.” Journal of Black Psychology,24 (1998): 211–225.

J. A. Baldwin, “Psychological aspects of European cosmology in American society.” Western Journalof Black Studies, 9 (1985): 216–223.

J. Baron, “Thinking and Deciding” New York: Cambridge University Press, (1990).F. Z. Belgrave, D. R. Brome, and C. T. Hampton, “The contribution of Afrocentric values and racial

identity to the prediction of drug knowledge, attitudes, and use among African American youth.”Journal of Black Psychology, 26(4) (2000): 386–401.

C. E. Berganza, J. E. Mezzich, et al. “The Latin American Guide for Psychiatric Diagnosis: A CulturalOverview.” Psychiatric Clinics of North America, 24 (2001): 433–446.

M. E. Bernal, and F. G. Castro, “Are clinical psychologists prepared for service and research withethnic minorities?” American Psychologist, 49 (1994): 797–805.

R. K. Blashfield, and A. K. Fuller, “Predicting the DSM-V.” Journal of Nervous and Mental Disease,184 (1996): 4–7.

F. Boateng, “African traditional education: A tool for intergenerational communication.” In AfricanCulture: The Rhythms of Unity. Eds. MK Asante and KW Asante (Trenton, NJ: Africa WorldPress, 1990 ).

E. Bolaji Idowu, Oludumare: God in Yoruba belief (New York: Wazobia 1994).G. C. Bowker, and S. L. Star, Sorting Things Out: Classification and Its Consequences (Cambridge:

MIT Press, 2000).N. Boyd-Franklin Black Families in Therapy: A Multisystems Approach (New York: Guilford,1989).A. M. Brandt, “Behavior, disease, and health in the twentieth-century United States: The moral valence

of individual risk.” In Morality and Health, Eds. A. M. Brandt, and P. Rozin (New York: Routledge,1997).

J. E. Brent, and G. B. Callwood, “Culturally relevant psychiatric care: The West Indian as a client.”Journal of Black Psychology, 19 (1993): 290–302.

R. T. Carter, The Influence of Race and Racial Identity in Psychotherapy (New York: John Wiley &Sons 1995).

V. R. Cherry, F. Z. Belgrave, et al. “NTU: An Africentric approach to substance abuse preventionamong African American youth.” Journal of Primary Prevention, 18 (1998): 319–339.

L. Comas–Diaz, and B. Greene, (eds.). Women of Color: Integrating Ethnic and Gender Identities inPsychotherapy (New York: Guilford 1994).

R. H. Dana, Multicultural Assessment Perspectives for Professional Psychology (Boston: Allyn &Bacon 1993).

M. P. DelBello, M. P. Lopez-Larson, et al. “Effects of race on psychiatric diagnosis of hospitalizedadolescents: A retrospective chart review.” Journal of Child and Adolescent Psychopharmacology,11, (2001): 95–103.

D. Dennard, “Application of the Azibo nosology in clinical practice with Black clients: A case study.”Journal of Black Psychology, 24 (1998): 182–195.

F. J. Diaz, and J. DeLeon, “Excessive Antipsychotic Dosing in 2 U.S. State Hospitals.” Journal ofClinical Psychiatry, 63 (2002): 998–1003.

A. B. Evarts, “Dementia Precox in the Colored Race.” Psychoanalytic Review, 14 (1913): 388–403.H. Fabrega, “Cultural and historical foundations of psychiatric diagnosis.” In Culture and Psychiatric

Diagnosis: A DSM-IV Perspective. Eds. J. E. Mezzich, A Kleinman, et al. (Washington, DC:American Psychiatric Press 1996).

H. Fabrega, J. Mezzich, and R. Ulrich. “Black-white differences in psychopathology in an urbanpsychiatric population.” Comprehensive Psychiatry, 29 (1988): 285–297.

H. Fabrega, “Culture and history in psychiatric diagnosis and practice.” Psychiatric Clinics of NorthAmerica, 24 (2001): 391–405.

H. H. Fairchild, “Scientific racism: The cloak of objectivity.” Journal of Social Issues, 47, 3(1991):101–115.

R. E. Fancher, Pioneers of Psychology (2nd ed.) (New York: Norton 1990).

234 Kwate

S. Fernando, Mental Health, Race and Culture (New York: St. Martin’s Press, 1991).B. J. Fowers, and F. C. Richardson, “Why is multiculturalism good?” American Psychologist, 51,

(1996): 609–621.A. Frances, and R. Ross, DSM-IV Case Studies: A Clinical Guide to Differential Diagnosis

(Washington, DC: American Psychiatric Press 1996).R. B. Franklin, and S. Pack-Brown, “Team Brothers: An Africentric approach to group work with

African American male adolescents.” Journal for Specialists in Group Work, 26 (2001): 237–245.A. D. Gaines, “From DSM-I to DSM-III-R; voices of self, master and the other: A cultural con-

structivist reading of U.S. psychiatric classification.” Social Science and Medicine, 35 (1992):3–24.

S. Gopaul-McNicol, Working with West Indian Families (New York: Guilford 1993).B. Greene, “Considerations in the Treatment of Black Patients by White Therapists.” Psychotherapy,

22 (1985): 389–393.B. Greene, “What difference does a difference make?: Societal privilege, disadvantage, and discord

in human relationships.” In Diversity in Human Interactions: The Tapestry of America, Eds.Robinson JD and LC James (London: Oxford 2003).

A. Gursoy, “Beyond the orthodox: Heresy in medicine and the social sciences from a cross-culturalperspective.” Social Science and Medicine, 43 (1996): 577–599.

R. V. Guthrie, Even the Rat Was White (2nd ed.) (Boston: Allyn & Bacon 1998).J. Haley, Learning and Teaching Therapy (New York: Guilford 1996).P. A. Hays, “Multicultural applications of cognitive-behavior therapy.” Professional Psychology:

Research and Practice, 26 (1995): 3 309–315.J. E. Helms, and R. M. Talleyrand, “Race is not ethnicity.” American Psychologist, 52 (1997): 1246–

1247.P. Hill, “Africentric rites of passage: Nurturing the next generation.” In Counseling African Amer-

ican families: The family psychology and counseling series, Eds. Sanders JL and C. Bradley(Alexandria, VA: American Counseling Association 2003).

K. K. Kambon, The African Personality in America: An African-centered framework (Tallahassee,FL: Nubian Nation 1992).

A. Kleinman, “Triumph or pyrrhic victory? The inclusion of culture in DSM-IV.” Harvard Review ofPsychiatry, 4 (1997): 343–344.

B. Lewis, “Psychiatry and postmodern theory.” Journal of Medical Humanities, 21 (2000): 71–84.E. T. Liu, “The uncoupling of race and cancer genetics.” Cancer, 83 (1998): 1765–1769.D. Longshore, C. Grills, et al. “Promoting recovery from drug abuse: An Africentric intervention.”

Journal of Black Studies, 28 (1998): 319–332.T. M. Luhrmann, Of Two Minds: The Growing Disorder in American Psychiatry (New York: Knopf

2001).J. Mbiti, “Man in African religion.” In Africa and the West: The legacies of Empire, Eds. IJ Mowoe

and R Bjornson (New York: Greenwood 1986).J. S. Mbiti, “African Religions and Philosophy (2nd ed.) (Oxford: Heineman Educational Publishers

1990).”J. E. Mezzich, and L. J. Kirmayer, et al. “The place of culture in DSM-IV.” Journal of Nervous and

Mental Disease, 187 (1999): 457–464.J. E. Mezzich, C. E. Berganza, and M. A. Ruiperez, “Culture in DSM-IV, ICD-10, and evolving

diagnostic systems.” Psychiatric Clinics of North America, 24 (2001): 407–419.S. Minsky, W. Vega, et al. “Diagnostic patterns in Latino, African American, and European American

psychiatric patients.” Archives of General Psychiatry, 60 (2003): 637–644.G. C. Nagayama Hall, “Misunderstandings of multiculturalism: Shouting fire in crowded theaters.”

American Psychologist, 52 (1997): 654–655.G. C. Nagayama Hall, and G. G. Maramba, “In search of cultural diversity: Recent literature in cross-

cultural and ethnic minority psychology.” Cultural Diversity & Ethnic Minority Psychology, 7(2001): 12–26.

A. M. Neal-Barnett, and J. Smith, “African Americans.” In Cultural Issues in the Treatment of Anxiety,Ed. S. Friedman (New York: Guilford 1997).

C. W. Nuckolls, “Toward a cultural history of the personality disorders.” Social Science and Medicine,35 (1992): 37–47.


A. O. Ogbonnaya, “Person as community: An African understanding of the person as an intrapsychiccommunity.” Journal of Black Psychology, 20 (1994): 75–87.

G. M. Oppenheimer, “Paradigm lost: Race, ethnicity, and the search for a new population taxonomy.”American Journal of Public Health, 91 (2001): 1049–1055.

K. A. Opoku, Hearing and Keeping: Akan Proverbs (Accra, Ghana: Asempa Publishers 1997).J. E. Oshodi, “The place of spiritualism and ancient Africa in American psychology.” Journal of Black

Studies, 27 (1996): 172–182.O. Owomoyela, Yoruba trickster tales. (Lincoln, NE: University of Nebraska Press 1997).S. M. Rosoff, and M. C. Leone, “The public prestige of medical specialties: Overviews and undercur-

rents.” Social Science and Medicine, 32 (1997): 321–326.C. E. Semmes, “Racism, Health, and Post-Industrialism: A theory of African-American Health

(Westport, CT: Praeger 1996).”M. Shostak, Nisa: The Life and Words of a !Kung Woman (New York: Vintage 1983).W. Soyinka, “The African world and the ethnocultural debate.” In African Culture: The Rhythms of

Unity, Eds. Asante MK and KW Asante (Trenton, NJ: Africa World Press (1990)).S. M. Strakowski, H. S. Lonozak, et al. “The effects of race on diagnosis and disposition from a

psychiatric emergency service.” Journal of Clinical Psychiatry, 56 (3) (1995): 101–107.S. M. Strakowski, J. M. Hawkins, et al. “The effects of race and information variance on disagreement

between psychiatric emergency service and research diagnoses in first-episode psychosis.” Journalof Clinical Psychiatry, 58 (1997): 457–463.

S. Sue, “Science, ethnicity, and bias: Where have we gone wrong?” American Psychologist, 54 (1999):1070–1077.

S. Sue, and N. Zane, “The role of culture and cultural techniques in psychotherapy: A critique andreformulation.” American Psychologist, 42 (1987): 37–45.

D. W. Sue, R. P. Bingham, L. Porche-Burke, and M. Vasquez, “The diversification of psychology: Amulticultural revolution.” American Psychologist, 54 (1999): 1061–1069.

T. Szasz, The myth of mental illness: Foundations of a theory of personal conduct (New York: Dell,1961).

S. B. Thomas, “The color line: Race matters in the elimination of health disparities.” American Journalof Public Health, 91 (2001): 1046–1048.

A. Thomas, and S. Sillen, Racism and Psychiatry (New York: Carol Publishing 1972, 1991).H. C. Triandis, and E. M. Suh, “Cultural influences on personality.” Annual Review of Psychology, 53

(2002): 133–160.S. J. Trierweiler, H. W. Neighbors, et al. “Clinician attributions associated with the diagnosis of

schizophrenia in African American and non-African American patients.” Journal of Consultinand Clinical Psychology, 68 (2000): 171–175.

A. L. Whaley, “Ethnicity/race, paranoia, and psychiatric diagnoses: Clinician bias versus socioculturaldifferences.” Journal of Psychopathology and Behavioral Assessment, 19 (1997): 1–20.

A. N. Wilson, “Black-on-Black violence: The psychodynamics of Black self-annihilation in service ofWhite domination” (New York: Afrikan World InfoSystems 1990).

P. Wolpe, “The holistic heresy: Strategies of ideological challenge in the medical profession.” SocialScience and Medicine, 31 (1990): 913–923.

P. R. Wolpe, “The dynamics of heresy in a profession.” Social Science and Medicine, 39 (1994):1133–1148.

B. E. Wright, “Black suicide: Lynching by any other name is still lynching.” Black Books Bulletin, 7(2) (1991): 15–17.

D. R. Wright, African Americans in the colonial era: From African origins through the Americanrevolution (Arlington Heights, IL: Harlan Davidson 1990).

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The Heresy of African-Centered Psychology · The Heresy of African-Centered Psychology Naa Oyo A. Kwate1 This paper contends that African-centered models of psychopathology represent